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A Survey of Patterns of Practice and Perception of Minimal Hepatic Encephalopathy: A Nationwide Survey in India.

Background/Aim: Minimal hepatic encephalopathy (MHE) leads to overt hepatic encephalopathy (HE) and impairs quality of life in patients with cirrhosis. Awareness of MHE and its management among physicians is not known. Patients and Methods: We conducted a survey among 673 physicians in India from ac...

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Published in:Saudi Journal of Gastroenterology Vol. 20; no. 5; pp. 304 - 309
Main Authors: Sharma, Praveen, Sharma, Barjesh C.
Format: research tables/charts Journal Article
Published: Wolters Kluwer India Pvt Ltd Sep/Oct2014
Online Access:View this record in EBSCOhost
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      jtl: Saudi Journal of Gastroenterology
      issn: 13193767
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      dt: Sep/Oct2014
      vid: 20
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      pub: Wolters Kluwer India Pvt Ltd
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        10.4103/1319-3767.141692
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      tig:
        atl: A Survey of Patterns of Practice and Perception of Minimal Hepatic Encephalopathy: A Nationwide Survey in India.
      aug:
        au:
          Sharma, Praveen
          Sharma, Barjesh C.
        affil: Department of Gastroenterology and Hepatology, Sir Ganga Ram Hospital New Delhi, India
      sug:
        subj:
          Hepatic Encephalopathy Therapy
          Practice Patterns
          Case Management
          India
          Human
          Academic Medical Centers
          Surveys
          Severity of Illness
          Chi Square Test
          Fisher's Exact Test
          Mann-Whitney U Test
          Wilcoxon Rank Sum Test
          Physicians
          Quality of Life
      ab: Background/Aim: Minimal hepatic encephalopathy (MHE) leads to overt hepatic encephalopathy (HE) and impairs quality of life in patients with cirrhosis. Awareness of MHE and its management among physicians is not known. Patients and Methods: We conducted a survey among 673 physicians in India from academic and nonacademic institutes to understand the clinical burden, perceived severity, management patterns, and the barriers to providing care for this condition. Results: Overall awareness of MHE in this survey was 75% (n = 504). Awareness of MHE was significantly higher in physicians working in teaching hospitals compared with those in nonteaching hospitals (79% vs 71%, P = 0.02). Similarly, gastroenterologists were more aware of MHE compared with nongastroenterologists (91% vs 66%, P = 0.001). Only 6.3% physicians screened all of their patients for MHE, whereas frequency of testing for MHE, either being nil or less than 10% of their patients was 64.7%. The most common test was paper and pencil test (86%) and the reason for nonscreening was nonavailability of time to test and also equipment or method (81%). A majority of physicians (88%) think that MHE affects quality of life. Physicians (61%) had an opinion that there should be some registry of MHE regardless of the cost and effort involved. Lactulose was used in 93% of cases, followed by rifaximin (82%) in the management of MHE. Conclusion: The overall awareness of MHE was 75% and it was significantly more in physicians of academic institutes. Despite awareness of its effect on quality of life, a majority of physicians did not test for MHE in their day‑to‑day practice.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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